Impact of ruxolitinib on the natural history of primary myelofibrosis: a comparison of the DIPSS and the COMFORT-2 cohorts.
(2014) Blood — Vol. 123, n° 12, p. 1833-1835 (2014)
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- The international prognostic scoring system [IPSS] provides reliable risk assessment in patients with primary myelofibrosis (PMF). Recent clinical trials in PMF patients with intermediate-2 or high IPSS risk have shown a survival advantage of ruxolitinib over placebo (COMFORT-1) or best available therapy (COMFORT-2). Since crossover was allowed in these studies, we analyzed the cohort of ruxolitinib-naive patients used for developing the dynamic IPSS (DIPSS). By adopting ad hoc statistical analyses, we compared survival from diagnosis of 100 PMF patients receiving ruxolitinib within COMFORT-2 with that of 350 patients of the DIPSS study. Subjects were properly matched, and both left-truncation and right-censoring were accounted in order to compare higher IPSS risks exclusively. Patients receiving ruxolitinib had longer survival (5 years, 95% CI 2.9-7.8, versus 3.5 years, 95% CI 3.0-3.9) with a hazard ratio of 0.61 (95% CI 0.41-0.91, P=.0148). This observation suggests that ruxolitinib may modify the natural history of PMF.
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Passamonti, F., Maffioli, M., Cervantes, F., Vannucchi, A., Morra, E., Barbui, T., Caramazza, D., Pieri, L., Rumi, E., Gisslinger, H., Knoops, L., Kiladjian, J.-J., Mora, B., Hollander, N., Pascutto, C., Harrison, C., & Cazzola, M. (2014). Impact of ruxolitinib on the natural history of primary myelofibrosis: a comparison of the DIPSS and the COMFORT-2 cohorts. Blood, 123(12), 1833-1835. https://doi.org/10.1182/blood-2013-12-544411 (Original work published 2014)